The Distal Gastric Digestive Tract Reconstruction After Radical Way Of Three Traditional Surgical Options

Purpose:Distal gastric resection is the primary means of treatment of gastric cancer,gastrointestinal surgery reconstruction is essential for the recovery of patients. Inthese method of digestive tract reconstruction, the BillrothI, BillrothⅡ, Roux-en-Yanastomosis were clinically most common traditional operation.Through comparativestudy of these three common gastrointestinal reconstruction complications and qualityof life, and to explore a reasonable choice distal gastric cancer after radicalreconstruction of the digestive tract.Method:Between August2011and December2012,71consecutive patients of distalgastric cancer selected in the postoperative period in patients with digestive tractreconstruction, in the First Affiliated Hospital of Nanchang University. as requireddigestive tract reconstruction;18patients with completed BillrothI anastomosis,26patients with complete BillrothⅡ anastomosis,27cases with Roux-en-Y anastomosis.Comparison of the three groups of patients operative time (min), blood loss (ml),postoperative discharge time (d), disconnect the tube after time (d), postoperativehospital stay (d), etc., and common postoperative evaluation indicators, such as therecovery of gastrointestinal function (including nausea, vomiting, abdominal pain,bloating, diarrhea, constipation, etc.), the nutritional status of patients (eating, themeal intake, eating frequency, weight, etc.), statistical analysis, in order tocomparison statistical significance.Results:1.Preoperative indicators: three groups of selecting patients with no significantdifference (P>0.05) in age, gender, pathological type and TNM staging, and there isno statistical significance.2.The three groups of surgical patients and complex surgical operations werepositively correlated, which Billroth I anastomosis surgery the most simple, time-consuming (average time191.8min) and bleeding (bleeding time was147.5ml) at least, and Roux-en-Y anastomosis operation most complex, timeconsuming (average time210.5min) and bleeding (mean bleeding time was203.8ml)Up; other research indicators, no significant difference (P>0.05), there is no nostatistical significance.3. three groups of patients after3months of follow-up symptoms and rating:reflux heartburn:BillrothI anastomosis anastomosis group and Billroth Ⅱ groupscore higher than the low Roux-en-Y anastomosis group (three groups of data were1.7±0.3,1.6±0.5,2.2±0.6) P<0.05, significant difference was statistically significant.Description Roux-en-Y anastomosis groups reflux heartburn symptoms over theprevious two to light. Other follow-up indicators are no significant differences (P>0.05), there is no statistically significant.Conclusion:Distal gastric digestive tract reconstruction after radical way of three traditionalsurgical options,it is not simply to do a single choice, but should line the digestivetract reconstruction different depending on the circumstances, BillrothI anastomosissurgery the most simple, the closest person fewer complications in normalphysiology, digestive disorders caused by internal and external secretory function.Roux-en-Y anastomosis complicated to operate, but in the prevention of a variety ofcomplications have obvious advantages, especially reflux gastritis. TraditionalBillroth Ⅱ anastomosis, there is no obvious advantage.